Key result
Severe aortic stenosis was associated with a high prevalence of sleep apnoea (71%) and significantly greater apnoea-hypopnoea index severity compared to matched controls (23/h vs 12/h; p<0.01).
Why the study?
Is sleep apnoea more prevalent and severe in patients with severe aortic stenosis compared to matched controls?
Cross-Sectional (n=67)
Is sleep apnoea more prevalent and severe in patients with severe aortic stenosis compared to matched controls?
Absolute Event Rate: 23% vs 12%
p-value: p=<0.01
Sleep apnoea is highly prevalent in patients with severe aortic stenosis, and the severity of central sleep apnoea correlates with pulmonary hypertension.
Supports sleep apnoea screening consideration in severe aortic stenosis; leaves open whether treatment alters outcomes.
BACKGROUND: There are as yet no data on the prevalence of sleep apnoea in patients with severe aortic stenosis (AS). AIMS: To assess the occurrence, severity and clinical correlates of sleep apnoea in patients with AS. METHODS: During a 4-month period in 2010, 67 patients were consecutively included in this study, 42 of which (19 men; mean±SD age 72±9 years) had severe AS (aortic valve opening area≤1.0 cm2); all were investigated with cardiorespiratory polygraphy. Sleep apnoea was diagnosed if the apnoea-hypopnoea index (AHI) (median (lower quartile, upper quartile)) was ≥5/h. The control group of 25 patients matched for age, body mass index and sex had angiographic exclusion of coronary artery disease, regular left ventricular ejection fraction, and no valve disease. RESULTS: Sleep apnoea was found in 30/42 patients with AS (71%; AHI=23/h (14/h, 36/h)). The severity was significantly greater in patients with severe AS than in the control group (AHI=12/h (8/h, 17/h)) (p<0.01). Half of the patients with sleep apnoea had obstructive sleep apnoea (OSA) (AHI=15/h (9/h, 28/h)), and half had central sleep apnoea (CSA) (AHI=25/h (18/h, 45/h)). New York Heart Association classification and severity of sleep apnoea correlated with η=0.5 (η2=0.3). The severity of CSA correlated with pulmonary artery pressure (r=0.7, p<0.01) and pulmonary capillary wedge pressure (r=0.7, p<0.01). Patients with AS and CSA had a lower PCO2 than those with OSA and those without sleep apnoea (p<0.01). CONCLUSIONS: Sleep apnoea is common in patients with severe AS. The severity of CSA correlates with pulmonary hypertension, which may suggest that myocardial adaptation is exhausting.
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Prinz et al. (2011) conducted a cross-sectional in Severe aortic stenosis (n=67). Severe aortic stenosis vs. Matched controls without valve disease, regular LVEF, and no coronary artery disease was evaluated on Apnoea-hypopnoea index (AHI) (p=<0.01). Severe aortic stenosis was associated with a high prevalence of sleep apnoea (71%) and significantly greater apnoea-hypopnoea index severity compared to matched controls (23/h vs 12/h; p<0.01).
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